| Organization Name: | JUSTIN SULLIVAN PT PLLC |
| NPI Number: | 1457624298 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTIN SULLIVAN (OWNER) |
| Mailing Address: | 360 State Route 17m Ste 4 Monroe |
| State: | NY US |
| Postal Code: | 109503444 |
| Phone Number: | 8458100078 |
| Fax Number: | 8452622466 |
| NPI Enumeration Date: | 02/09/2012 |
| NPI Last Update Date: | 02/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 033294 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |